Background In the United States, already-prevalent power outages are increasing in frequency and duration with climate change. Studies from New York State show that power outages may increase hospitalizations for cardiovascular disease (CVD) and respiratory disease in vulnerable populations such as older adults, but exposure data limitations have constrained nationwide studies of power outages and health. Here, we tested if power outages were associated with emergency CVD and respiratory disease-related hospitalizations among older adults in the United States. Methods and findings We developed a national dataset of power outage exposure and identified county-days with ≥1% of customers exposed to 8+ hour power outages in 2018. We leveraged data on 23 million Medicare Fee-For-Service beneficiaries aged 65+ to estimate daily county-level rates of emergency CVD- and respiratory-related hospitalizations. We applied a case-crossover design with a conditional Poisson model to estimate the lagged association (up to 1 week) between daily county-level power outage exposure and cause-specific hospitalization rates. Models controlled for daily temperature, precipitation, and wind speed. Results Power outages were associated with increased emergency CVD and respiratory hospitalizations. The association between power outage and CVD hospitalizations was strongest the day after power outage exposure (rate ratio RR=1.02, 95% CI: 1.01, 1.03), while the association between outage and respiratory disease was strongest the day of power outage exposure (RR = 1.03, 95% CI: 1.01, 1.04). We estimated this association using county-level power outage data; future studies could use higher spatial resolution data. Conclusions Power outages may increase the risk of CVD and respiratory hospitalizations among US older adults. Improving electricity reliability could support community health and protect older adults from CVD and respiratory disease exacerbations.
McBrien et al. (Thu,) studied this question.